NPIMap

Organization Active NPI

St Mary'S Pediatric Care PLLC

  • Pediatrics Physician
  • Palm Harbor, FL
National Provider Identifier
1659778231
Registry record updated Nov 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME105372 Issued in FL
Legal business name
ST MARY'S PEDIATRIC CARE PLLC
Practice address
2626 Tampa Rd
Suite 101
Palm Harbor, FL 34684-3155
Phone
(727) 754-1984
Fax
(727) 754-2868
NPI assigned
Nov 26, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Eid Guirguis, MD
Title
Owner
Phone
(727) 754-1984

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X ME105372 FL Primary

Addresses

Primary practice location

2626 Tampa Rd
Suite 101
Palm Harbor, FL 34684-3155

Mailing address

2626 Tampa Rd
Suite 101
Palm Harbor, FL 34684-3155
Phone (727) 754-1984

Other identifiers 1

IdentifierTypeStateIssuer
0015657MedicaidFL

National Provider Directory

National Provider Directory

Locations

2626 Tampa Rd
Ste 101
Palm Harbor, FL 34684
Phone (724) 754-1984

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416960000000",
    "number": "1659778231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 TAMPA RD",
            "address_2": "SUITE 101",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843155",
            "telephone_number": "727-754-1984",
            "fax_number": "727-754-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 TAMPA RD",
            "address_2": "SUITE 101",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346843155",
            "telephone_number": "727-754-1984",
            "fax_number": "727-754-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MARY'S PEDIATRIC CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-26",
        "last_updated": "2014-11-26",
        "status": "A",
        "authorized_official_last_name": "GUIRGUIS",
        "authorized_official_first_name": "EID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-754-1984",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME105372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015657",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.